May 26, 2015

Why is Shisha (hookah) smoking on the rise?

The Canadian Charger

While anti-smoking campaigns have helped reduce cigarette smoking amongst young people in Canada, Shisha (hookah) smoking is increasing in this same age group, according researchers with the Propel Centre for Population Health Impact at the University of Waterloo.

A recent study by the Propel Centre, which analyzed
data from the national 2012-2013 Youth Smoking, found that nearly one in four
high school students have smoked a hookah, also known as a water pipe.

The Youth Smoking Survey 2012/2013 was administered to
27,404 Canadian grades 9–12 students attending schools in nine Canadian
provinces representing 96 per cent of the Canadian population.

The study also found that smokers have an 18 per cent
higher probability of using a hookah than non-smokers, and students with more
spending money have significantly higher odds of hookah use compared with those
with no spending money.

Dr. Leia Minaker, a scientist at the Propel Centre for
Population Health Research, who conducted the study, funded by the Canadian
Cancer Society, said her research team found that hookah use amongst Canadian
youth has been significantly increasing over time.

“We found that among grades 9-12 students in Canada
... Fourteen per cent of grades 9-12 students have tried hookah, and that
number is almost one-quarter (23 per cent) among high school seniors. Boys have
a higher chance of using hookah than girls,” Dr. Minaker said.

Meanwhile, few national tobacco surveillance systems
address hookah use. Results of the Propel Centre study suggest that tobacco use
surveillance systems should include alternate tobacco product use since
excluding certain types of other tobacco products underestimates prevalence
estimates of tobacco use.

The tobacco used that has been soaked in honey or
molasses – is the product smoked in a hookah. Dr. Minaker said, recently the
tobacco industry has been adding other manufactured flavours to the tobacco.

“The tobacco industry uses fun and fruity flavours to
entice youth to try tobacco products. You can now get flavoured shisha in
Canada called “Scooby Snack,” “Baby Doll” (which apparently tastes like Double
Bubble gum), and Orange Soda. I think most Canadians recognize that those are
all child-friendly flavours.”

She cited the increasing trend of adding manufactured
flavours to Shisha and using these flavours to market the product as a major
reason why hookah smoking is becoming more popular amongst young people.

Moreover, a lot of people think hookah smoking is not as harmful as smoking
cigarettes. The Propel Centre study found that among students in grades 9-12 in
Canada, 38 per cent believe that hookah is less harmful than cigarettes.

But Dr. Minkaker said this is another misconception.

“When people smoke hookah, the smoke bubbles up
through the water in the pipe. The smoke is cool and less harsh than cigarette
smoke, especially if it’s flavoured. Many people mistakenly believe that the
water filters the smoke, but all the toxic chemicals remain in the smoke that
the user breathes in.”

She added that not only are the toxic and
cancer-causing components in cigarette smoke are also in hookah smoke, but they
may be in even in bigger amounts.

Due to the co-use of cigarettes and hookahs and the
simultaneous increase in the use of hookahs and the decrease in the use of
cigarettes, the Propel Centre's report suggests that governments should
consider how to limit non-traditional tobacco use amongst young people.

There is a small but growing number of municipalities
in Canada that have prohibited hookah smoking in restaurants, bars, cafes,
patios and even outdoors on municipal property. A couple of Canadian provinces
have prohibited hookah smoking in public places, but cigar and hookah bars may
be exempt.

Dr. Minkaker also denounces the justification that
hookah smoking is “part of our culture” so it should be accepted.

“Hookah is an ancient form of tobacco smoking, and
it’s done in a traditional, Middle Eastern pipe. People who oppose hookah
restrictions in public places might say, 'Hookah smoking is our traditional
cultural activity', which is true. It is
a cultural activity that is actually banned in several of the countries where
it has strong, traditional roots. Several countries have banned indoor hookah
smoking, including Lebanon, Turkey, and parts of Saudi Arabia and India. But
more importantly, even if those countries hadn’t banned it, the cultural
activity argument isn’t great – there are a lot of things that are allowed in
other countries that are not allowed in Canada – take cigarette smoking in
workplaces, for example!”

The Canadian Cancer Society reports lung cancer as the
leading cause of cancer death in Canada. It is estimated that 85 per cent of
lung cancer cases are related to using tobacco products.